Wealthy nations must follow through on disease fight

Mathuram Santosham

In 1980, I moved my family from Maryland to the White Mountain Apache Reservation in Arizona to work on an issue most people are not comfortable talking about — diarrhea. At the time, diarrhea, which is preventable and treatable, was rampantly killing children on the reservation at a rate seven times the national average.

Working hand-in-hand with tribal leadership, we introduced oral rehydration solution (ORS) — a mixture of sugar, salt and water — to treat the deadly dehydration diarrhea can cause. At the time, ORS was new and game changing. On the reservation, its effects were remarkable. Diarrhea deaths were virtually eliminated.

While deaths from diarrhea are rare in the United States, diarrhea continues to be ranked among the leading killers of children globally, taking more lives than HIV/AIDS, TB and malaria combined.

The good news is that in addition to time-tested treatments like ORS, we have a powerful new weapon in our arsenal — rotavirus vaccines, preventing the most common and deadly cause of diarrhea. The problem is that, while these vaccines are extensively used in affluent countries like ours, they are not available in many of the world's poor countries.

Today, my work at the Johns Hopkins Bloomberg School of Public Health takes me from the busy streets of Baltimore to the congested lanes of Delhi, India — where, like much of the world, the health inequities are vast. But whether you are from the wealthy suburbs of Baltimore or the poorest villages in Uttar Pradesh, India, every parent wants the same thing for their child: the opportunity to live a full, healthy life.

Vaccines offer the hope of a healthy life to every child. They are one of the best investments we can make in our future, and they're incredibly cost effective. With just a few doses, they provide a lifetime of protection against some of the biggest threats we face. Take rotavirus, for example. Every child, regardless of where he or she is born, is at risk. But while children in the U.S. with access to vaccines and medical treatment recover from it, in countries where prevention and care are limited, rotavirus infection is often a death sentence. In fact, rotavirus kills more than 500,000 children worldwide each year.

Vaccines provide the best protection against rotavirus. In the U.S. alone, rotavirus vaccinations reduced rotavirus-related hospitalizations by as much as 86 percent. If made widely available, these vaccines will have a powerful, lifesaving impact in poor countries where the greatest needs exist. But we have to get them there first.

In 2000, the GAVI Alliance, a public-private partnership, was formed to protect children in poor countries from vaccine-preventable diseases. Since then, GAVI has supported the vaccination of nearly 300 million children and prevented 5 million deaths. GAVI has committed to supporting the introduction of rotavirus vaccine in 40 of the world's poorest countries but needs financial support to do so.

Recently, two of the world's biggest rotavirus vaccine manufacturers — GlaxoSmithKline and Merck — announced deep cuts to the price of their rotavirus vaccines, a tremendous milestone that will help GAVI stretch its resources to vaccinate more children.

Today, world leaders will come together in London to pledge their support for GAVI. If fully funded, GAVI can immunize more than 240 million children — including more than 50 million against rotavirus — saving 4 million additional lives by 2015. But pledges are no more than that — pledges — until they are delivered.

President Barack Obama pledged U.S. support to ensure GAVI "has the resources it needs to do its job." I applaud the president for his commitment.

In the words of Nobel laureate Gabriela Mistral, "We are guilty of many errors ... but our worst crime is abandoning the children, neglecting the fountain of life. Many of the things we need can wait. The child cannot ... to him we cannot answer, 'tomorrow.' His name is 'Today.'"

Investing in child health and vaccines, in particular, today is the best way to level the playing field for children everywhere. Healthy children build healthy families, societies, countries and economies. In today's interconnected world, where the shudders of one country's economy can be felt across the globe and deadly diseases are just a plane flight away, the health of children in places that seem far-off has real implications here at home. Now, it's time for the U.S. and other wealthy nations to follow through and deliver on their pledges. We must reach every child everywhere.

Dr. Mathuram Santosham is co-chair or the Rotavirus Organization of Technical Allies (ROTA) Council, director of the Center for American Indian Health and a professor of international health and pediatrics at the Johns Hopkins Bloomberg School of Public Health. His email is msantosh@jhsph.edu.